In response to news headlines declaring “doctors change in course on estrogen replacement therapy,” Dr. Christiane Northrup, MD, the OB-GYN and bestselling author comments, “This is nothing new.”

The media claim that it’s time to return to synthetic estrogen comes in response to a WHI (Women’s Health Initiative) study published this week in the New England Journal of Medicine. Like it’s predecessor, a prior WHI study on the health impact of synthetic estrogen replacement, this study was also funded by the NIH (National Institutes of Health) with major funding by Wyeth, the maker of Premarin, the hormone replacement drug being studied.

The earlier study had to be discontinued in 2002 because of the higher incidence of cancer, heart disease, and stroke among those taking the synthetic estrogen. This scared millions of women away from this form of hormone replacement.

But in this new round, study authors narrowed their focus and found what they claim is good news: for women who have had their female organs removed through surgery, taking synthetic estrogen replacement may help reduce one possible risk factor for heart attacks.

I asked Dr. Erika Schwartz, MD, a specialist on hormonal health, with a private practice in New York, who is affiliated with Downstate Medical College for a closer look into the study results.

ARL: “Are study results based on women who have had hysterectomies applicable to all women?”

Dr. Erika: “No, not in my opinion. For one thing, the women could have had a disease condition, requiring surgery that has not been taken into account. Healthy women with in tact ovaries might well experience entirely different results. As a woman, and a doctor who sees thousands of women patients, I would not equate them.”

ARL: “The study showed that taking the synthetic estrogen would prevent heart disease. Any comment?”

Dr. Erika: “Well, since there was no data taken before the women began treatment, it’s really not possible to say whether or not the plaque levels were due to the synthetic estrogen. They could have been low to begin with.”

ARL: “Are their other known ways to lower plaque levels?”

Dr. Erika: “Many. Diet is the most well-known.”

ARL: “What about the synthetic estrogen increasing risk for cancer?”

Dr. Erika: “That remains a real concern, that hasn’t changed.”

ARL: “So to summarize, in your view, synthetic estrogen relieves menopausal symptoms, may reduce one possible risk factor for heart disease, and still may increase risk for cancer — what should women do if they experience menopausal symptoms?”

Dr. Erika: “Many, many studies show that bio-identical hormones are safer than these synthetic products, which are derived from horses. That’s what I recommend, along with a healthy diet and lifestyle changes.”

Still trying to understand what was “new” I asked Dr. Northrup, “Why was this called “new?” Was anything “new” in the current study that in your opinion would dictate a change of course in treatment recommendations?”

“Wyeth (who produces the synthetic estrogen) came up with a new P.R. campaign,” she said.

For more information on options in treating menopausal symptoms, consult Dr. Northrup’s book, The Wisdom of Menopause (Warner, 2004) and Dr. Schwartz’ book, The 30 Day Natural Hormone Plan (Bantam 2006). I plan to go into this topic more fully in future blogs, and would love to hear your questions about this topic either here or at my website, www.HealthJournalist.com

Copyright, 2007, Alison Rose Levy. All rights reserved.

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